Lumbar nerve root compression with radiculopathy is a common cause of leg pain, sensory loss, weakness and reduced walking capacity. Decompression surgery can relieve symptoms when compression is clinically relevant, but outcomes depend on correct patient selection, concordance between symptoms and imaging, the response to conservative care and the patient’s own goals. In routine practice these elements are often considered informally and inconsistently. This paper presents a patient-centred, stage-gated protocol that organises the decision process into seven stages—screening, clinical characterisation, imaging correlation, structured conservative care, shared decision-making, decompression planning with peri-procedural safety, and rehabilitation with outcome review—separated by three explicit gates for red flags, clinical–imaging concordance and patient preference. The protocol was developed from a structured synthesis of trial evidence and clinical guidelines, stakeholder mapping and a set of design principles that place safety and patient goals alongside technical criteria. A concordance matrix links clinical presentation to imaging findings and assigns an action to each combination, and a follow-up schedule specifies validated outcome measures at six time points. The protocol is a design contribution: it does not report patient outcomes, and its content validity and clinical performance remain to be established through expert consensus and prospective evaluation.

Dr. Yuvraj Pandharinath Jadhav, "A Patient-Centred, Stage-Gated Decision Protocol for Lumbar Spinal Decompression in Nerve Root Compression and Radiculopathy" International Journal of Humanities and Social Sciences Research Studies, V1(4): Page(121-127) September-October 2026. ISSN: 3139-0854. www.ijhssrs.com. Published by Scientific and Academic Research Publishing.